Abstract

BackgroundTo document the pharmacotherapy of chronic heart failure (CHF) and to evaluate the adherence to treatment guidelines in Australian population.MethodsThe pharmacological management of 677 patients (female 46.7%, 75.5 ± 11.6 years) with CHF was retrospectively analyzed.ResultsThe use of angiotensin converting enzyme (ACE) inhibitors/angiotensin receptor blockers (ARB) and β-blockers were 58.2 % and 34.7 %, respectively. Major reasons for non-use of ACE inhibitors/ARBs were hyperkalemia and elevated serum creatinine level. For patients who did not receive β-blockers, asthma and chronic obstructive pulmonary disease were the main contraindications. Treatment at or above target dosages for ACE inhibitors/ARBs and β-blockers was low for each medication (40.3% and 28.9%, respectively).ConclusionsEvidenced-based medical therapies for heart failure were under used in a rural patient population. Further studies are required to develop processes to improve the optimal use of heart failure medications.

Highlights

  • Chronic heart failure (CHF) has emerged as a major public health problem in Australia

  • Accumulated evidence shows that angiotensin converting enzyme (ACE) inhibitors/Angiotensin II receptor blockers (ARBs) and β-blockers could reduce the high mortality in patients with chronic heart failure (CHF).[6,7]

  • We have shown that ACE inhibitors/ARBs and β-blockers were underused in patients with heart failure in a rural Australian hospital, compared with published guidelines

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Summary

Introduction

Chronic heart failure (CHF) has emerged as a major public health problem in Australia. Improved survival after myocardial infarction combined with an aging population, means a heart failure epidemic may appear within the two decades.[1,2,3] Despite considerable advances in treatment to increase long-term survival, CHF is still associated with a high mortality rate.[4]. Pharmacotherapy is an important component of CHF management which improves symptoms and reduces cardiac remodeling and neuro-endocrine activation to prevent worsening of symptoms and reduces mortality.[5] Accumulated evidence shows that ACE inhibitors/Angiotensin II receptor blockers (ARBs) and β-blockers could reduce the high mortality in patients with CHF.[6,7] better implementation of pharmacotherapy was associated with better prognosis in patients with CHF.[8,9]. To document the pharmacotherapy of chronic heart failure (CHF) and to evaluate the adherence to treatment guidelines in Australian population

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